This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (40)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Operative Complications and Long-term Results

Robin A. Bernhoft, MD; Carlos A. Pellegrini, MD; Lawrence W. Way, MD

Arch Surg. 1982;117(5):631-635.

Abstract
• We studied the clinical course of 35 patients with refractory ascites who underwent 51 peritoneovenous shunts. Nine of them had hepatorenal syndrome (HRS). Operative complications included shunt malfunction, shunt infection, ascitic leak, fluid overload, and disseminated intravascular coagulation. Two of the patients without HRS died postoperatively. The survival rate in this group was 67% at one year and 43% at two years. Ascites was completely controlled in 83% of the survivors at two months and 50% at two years. Neither survival nor shunt patency were predictable. The shunt reversed HRS in three patients, but failed to do so in the other six. Late complications included shunt malfunction and infection. During the first two years of follow-up, five patients bled from esophageal varices. Liver failure was the sole cause of late death. Peritoneovenous shunt should be reserved for patients with truly refractory ascites, for whom it provides excellent palliation.

(Arch Surg 1982;117:631-635)

Author Affiliations
From the Department of Surgery, University of California, San Francisco and the Surgical Service, Veterans Administration Medical Center, San Francisco.

Footnotes
Accepted for publication Dec 28, 1981.

Read at the 89th annual meeting of the Western Surgical Association, Albuquerque, Nov 17, 1981.

Reprint requests to Surgical Service (112), Veterans Administration Medical Center, 4150 Clement St, San Francisco, CA 94121 (Dr Pellegrini).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Transjugular Intrahepatic Portosystemic Stent-Shunt Procedure for Refractory Ascites
Ochs et al.
NEJM 1995;332:1192-1197.
ABSTRACT | FULL TEXT  

The Budd-Chiari Syndrome and Hepatic Veno-occlusive Disease: Recognition and Treatment
McDermott and Ridker
Arch Surg 1990;125:525-527.
ABSTRACT  

Management of Renal Complications of Liver Disease
Epstein et al.
J Intensive Care Med 1988;3:71-86.
ABSTRACT  

Peritoneovenous Shunts: Lessons Learned From an Eight-Year Experience With 70 Patients
Fulenwider et al.
Arch Surg 1984;119:1133-1137.
ABSTRACT